The Shoulder. Can a tear heal by itself?

Many patients think the only way to fix a tear is surgery.

Shoulder pain is a common complaint that can significantly impact daily activities and limit your range of motion. Whether it’s caused by an injury, overuse, or underlying defects, shoulder pain can affect people of all ages and lifestyles. In this blog post, we will explore the causes of shoulder pain, its impact on individuals, and how physical therapy can provide effective solutions for relief and rehabilitation.

Common Causes of Shoulder Pain

Shoulder pain can have various causes, including:

a) Rotator Cuff Injuries: The rotator cuff is a group of muscles and tendons that stabilize the shoulder joint. Injuries such as strains, tears, or impingement of the rotator cuff can result in shoulder pain and limited movement.

b) Frozen Shoulder (Adhesive Capsulitis): This condition causes the shoulder joint capsule to thicken and tighten, leading to stiffness, pain, and restricted mobility. This is often over-diagnosed, is rare, and is severely debilitating for up to and sometimes longer than a year.

c) Shoulder Bursitis: Inflammation of the bursae, fluid-filled sacs that cushion the shoulder joint, can cause pain, swelling, and limited range of motion.

d) Shoulder Arthritis: Osteoarthritis of rheumatoid arthritis can affect the shoulder joint, leading to pain, stiffness, and reduced function.

e) Labrum Tears: The labrum is like a large “suction cup” and keeps the ball in place within the socket. It spans 360 degrees around the head of the humerus (arm bone). A tear anywhere in this can cause instability and slipping of the shoulder within the socket. Larger tears can cause subluxation (partially slipping out of the socket) and full dislocation.

Surgery or PT?

Over the recent years more and more evidence has come to light which is showing Physical Therapy as “Just as effective” or “More effective” than surgery. One example is a recent study:

Researchers from Finland studied 173 people age 55 and older with non-traumatic rotator cuff tears. Each study participant was randomly assigned to a group of either physical therapy for their shoulder or surgery plus PT for their condition. They found that a significant number of people with rotator cuff tears were treated successfully with conservative measures, including physical therapy. There was no difference between groups 12 months after the intervention. They concluded that “conservative treatment should be considered as the primary method of treatment for this condition.”

The Role of Physical Therapy in Shoulder Pain Management

Physical therapy is a key approach to diagnose, treat, and manage shoulder pain. Here’s how physical therapy can help:

a) Thorough Assessment: A physical therapist will conduct a comprehensive evaluation of your shoulder, examining range of motion, strength, and any underlying biomechanical issues. This assessment helps determine the root cause of your pain.

b) Pain Relief Techniques: Physical therapists employ various modalities like manual therapy, heat or cold therapy, ultrasound, and electrical stimulation to reduce pain, inflammation, and promote healing.

c) Therapeutic Exercises: Customized exercise programs are designed to strengthen the muscles surrounding the shoulder joint, improve flexibility, and enhance stability. These exercises aim to restore function, reduce pain, and prevent further injuries. Luckily the shoulder has many accessory muscles that can assist the rotator cuff.

d) Manual Therapy Techniques: Physical therapists may use hands-on techniques such as joint mobilization, soft tissue mobilization, and stretching to improve shoulder mobility, reduce pain, and enhance tissue healing.

e) Posture and Body Mechanics Education: Physical therapists provide guidance on proper posture, ergonomics, and body mechanics during daily activities to minimize strain on the shoulder joint and promote optimal movement patterns.

f) Functional Rehabilitation: Physical therapy focuses on functional activities and movements specific to your daily routine or sport. Therapists will help you regain strength, coordination, and endurance to return to your desired activities safely.

Preventing Shoulder Pain Recurrence

Physical therapy aims to prevent future shoulder pain episodes. Your physical therapist will educate you on strategies to maintain shoulder health, including proper warm-up exercises, strengthening and stretching routines, and ergonomic modifications. They will also guide you on injury prevention techniques and self-care practices to reduce the risk of recurring shoulder pain.

Remember, taking proactive steps towards shoulder health today can lead to a pain-free and functional tomorrow.

Shane Capone

Doctor of Physical Therapy

Activate Physical Therapy

732-908-2610, info@activate-pt.com, https://activate-pt.com/